insurance-certificate-compliance

# CRE Insurance Certificate Compliance Review

Analyzes ACORD 25 certificates and endorsement copies against Access Agreement insurance requirements. Produces a compliance determination with broker-ready corrective instructions.

**Cardinal rule**: A COI is an informational snapshot only — it does not amend, extend, or alter coverage.

## Intake

Gather before drafting (unless user says "use defaults" or "just draft"):

1. **Executed Access Agreement** — all exhibits, insurance schedules, riders
2. **Certificates of insurance** — ACORD 25; separate forms for auto, WC, umbrella, professional, pollution
3. **Endorsement copies** — AI (CG 20 10, CG 20 37), primary/non-contributory, waiver of subrogation
4. **Broker contact details**
5. **Project description** — scope, dates, locations, hazard level

**Defaults if no response**: Review against standard CGL/auto/WC/umbrella; flag missing endorsements as non-compliant; produce deficiency instructions for all gaps.

If endorsements are missing, request them. If user insists on proceeding, label the review as **preliminary** with all conclusions conditional.

## Step 1: Build Verification Matrix

Extract the Agreement's insurance clause into testable requirements:

| Category | What to extract |
|---|---|
| Coverage lines | CGL, auto, WC/EL, umbrella/excess, professional, pollution, cyber |
| Limits | Per-occurrence, general aggregate, products/completed-ops aggregate, CSL, EL |
| Aggregate structure | Per-project, per-location, or policy-level |
| Additional Insured entities | Exact legal names with entity suffixes (owner, manager, lender, affiliates) |
| AI scope | Ongoing only vs. ongoing + completed operations |
| Required endorsement forms | Specific ISO form numbers or "or equivalent" |
| Primary & non-contributory | Required on which lines |
| Waiver of subrogation | Required on which lines |
| Carrier rating | AM Best minimum (typically A- VII) |
| Cancellation notice | Days' notice, to whom |
| Deductible/SIR caps | Maximum amounts |
| Occurrence vs. claims-made | Which lines must be occurrence form |

**Pitfalls**: Missing completed-operations AI requirement; entity name mismatches (e.g., "ABC Management" vs. "ABC Management, LLC"); assuming umbrella follows form without proof.

## Step 2: Review ACORD 25

| Field | Verify |
|---|---|
| Named Insured | Matches Recipient entity exactly (legal name + suffix) |
| Policy dates | Spans entire access period |
| CGL form type | "Occurrence" if contract requires it |
| CGL limits | Per-occurrence, general aggregate, products/completed-ops |
| Aggregate applies per | Project/location if required (not just "Policy") |
| Auto | "Any Auto" or required symbols; CSL meets minimum |
| WC/EL | Statutory WC; EL limits; no excluded officers performing work |
| Umbrella/Excess | Limits stack to contract total; follows form to required lines |
| Certificate Holder | Being listed as Certificate Holder does NOT grant AI status |

## Step 3: Verify Additional Insured Status

1. Confirm exact AI entities required (including affiliates language)
2. Determine endorsement type:
   - **Blanket** ("when required by written contract") — needs executed contract + endorsement copy
   - **Scheduled** (named entities) — confirm schedule lists correct names
3. Verify scope:
   - Ongoing only (CG 20 10) vs. ongoing + completed (CG 20 10 + CG 20 37)
   - "Caused in whole or in part" vs. vicarious liability only — varies by edition
4. **No endorsement copies = non-compliant** — issue deficiency notice requesting AI endorsements for entities listed in the Agreement

## Step 4: Verify Remaining Requirements

**Primary & Non-Contributory**:
- Separate from AI status — AI does not automatically mean primary
- COI narrative alone insufficient; require endorsement or policy provision
- Confirm not overridden by umbrella "other insurance" clause

| Requirement | Verification |
|---|---|
| Waiver of subrogation | Endorsement on each required line — COI checkbox insufficient |
| Umbrella AI | Confirm umbrella recognizes AI status; request declarations + endorsement |
| Carrier rating | AM Best confirmation or broker attestation |
| Cancellation notice | ACORD 25 standard language confers no notice rights; require endorsement |
| Deductible/SIR | Request declarations or broker letter; flag credit risk for large SIRs |
| Description of Operations | Check for exclusionary language (geographic limits, activity exclusions) |

## Step 5: Produce Compliance Determination

```
INSURANCE COMPLIANCE REVIEW
[Privileged and Confidential — Attorney-Client Communication]

Project: [Name/Address]
Recipient: [Entity]
Agreement Date: [Date]
Review Date: [Date]
Assumptions Used: [list]
Open Items / Needed Inputs: [list]

DETERMINATION: [Compliant / Non-Compliant / Conditionally Compliant]

REQUIREMENT-BY-REQUIREMENT ANALYSIS:
| # | Requirement | Contract Ref | Status | Evidence | Deficiency |
|---|---|---|---|---|---|
| 1 | CGL $1M occ / $2M agg | §[X] | Compliant | COI shows matching limits | — |
| 2 | AI - ongoing + completed ops | §[X] | Non-Compliant | No endorsement provided | Provide CG 20 10 + CG 20 37 |

BROKER INSTRUCTIONS:
[Numbered corrective actions with exact document requests]

ESCALATION ITEMS:
[Issues requiring attorney or coverage counsel review]
```

**Drafting rules**: Use "unable to verify" not "coverage will be denied." Distinguish: "confirmed" / "indicated but not verified" / "not shown — non-compliant."

## Jurisdiction Flags

| Jurisdiction | Issue | Action |
|---|---|---|
| **New York** | Labor Law §§240/241 strict liability (gravity injuries) | Check for "Labor Law"/"Heights"/"Action Over" exclusions; escalate to coverage counsel |
| **Texas** | Anti-Indemnity Act (Ins. Code Ch. 151) | Flag if access involves construction/alteration/repair |
| **California** | Civil Code §2782 limits risk-shifting (active negligence) | Confirm indemnity + AI requirements are consistent |
| **Florida** | Fla. Stat. §627.4137 claimant rights | Note if potential claim identified |

Flag state-law issues for local counsel. Do not assert universal rules about certificate legal effect.

## Post-Draft Checklist

After delivering the review, ask:

1. Does the determination match your understanding of coverage posture?
2. Additional entities to verify as AI?
3. Any deficiencies to escalate to coverage counsel instead of broker?
4. Follow-up check needed after broker cures?

## Quality Audit

Before finalizing:

- [ ] Every Agreement requirement mapped to a testable check
- [ ] Requirement table complete with status for each coverage line
- [ ] Entity names compared character-by-character (LLC, Inc., LP suffixes)
- [ ] No compliance finding based solely on COI without endorsement verification
- [ ] Broker instructions are specific (not generic "provide adequate coverage")
- [ ] Jurisdiction flags included where applicable
- [ ] Assumptions and open items listed prominently
- [ ] Every assertion traceable to a document or labeled as assumption
- [ ] Disclaimer: not a coverage opinion; requires licensed attorney review

## Guardrails

- **COI ≠ coverage**: Never approve compliance based solely on a certificate
- **Entity names must match exactly** — mismatches defeat AI coverage at claim time
- **No coverage opinions**: Compare contract requirements to documentary evidence only
- **Privilege**: Confirm with supervising attorney; third-party sharing may waive privilege
- **Anti-hallucination**: Do not invent policy terms or coverage conclusions; use `[VERIFY]` for unconfirmed details
- **Attorney review required**: Every deliverable must disclaim that it requires licensed attorney review before reliance